A Time-saving and Effective Technique Using SURGICEL™ Packing for Controlling Bleeding During Spinal Endoscopy Surgery

Abstract Background: Epidural venous bleeding during full-endoscopic lumbar decompression can obscure visualization, prolong operative time, and increase the risk of neural injury. Conventional hemostatic methods, such as bipolar cautery, carry a risk of thermal spread, while other hemostatic agents have limitations related to swelling, cost, or application complexity. Objectives: This study evaluates the efficacy and safety of the Surgicel™ packing technique for epidural venous bleeding control during spinal endoscopic decompression. Materials and Methods: A retrospective review was conducted of 40 patients undergoing lumbar endoscopic unilateral laminectomy for bilateral decompression for central lumbar spinal stenosis at a regional hospital in Taiwan. Sixteen patients (24 levels) received the Surgicel™ packing technique, and 24 patients (36 levels) served as controls. Operative time, mean arterial pressure (MAP) at admission and intraoperatively, use of additional hemostatic agents, and complications were recorded. Results: The mean operative time was significantly shorter in the Surgicel™ group compared with controls (72.5 ± 9.7 vs. 89.0 ± 11.6 min, P < 0.005). Additional hemostatic agents were required in 6.25% of Surgicel™ patients versus 33.3% of controls ( P < 0.005). No significant differences were found in preoperative or intraoperative MAP between groups. All epidural venous bleeding in the Surgicel™ group was controlled without recurrence. No complications, including dural tears, new-onset neuralgia, or delayed bleeding, were reported. Conclusions: The Surgicel™ packing technique is a safe, efficient, and cost-effective method for controlling epidural venous bleeding during full-endoscopic lumbar decompression. It reduces operative time and the need for additional hemostatic agents, with no observed complications. This technique may improve surgical efficiency. However, prospective, multicenter studies are warranted to validate these findings.